Historical Review and Recent Advances
in Neonatal and Perinatal Medicine

Edited by George F. Smith, MD and Dharmapuri Vidyasagar, MD
Published by Mead Johnson Nutritional Division, 1980
Not Copyrighted By Publisher

Introduction

Medical History

George F. Smith, M.D.

In putting forth a history of neonatology, it is expected that the papers will give some insight into the care of newborn infants from the earliest times. One problem in developing a medical history for neonatology and perinatology is that there have been so many new advances and discoveries which have occurred in recent times. A written record is a basic necessity for the proper recording of history. It is extremely difficult to evaluate history, even from well documented records, and it is almost impossible to evaluate historical events without them. It is also important, when interpreting medical history, to know the reactions of knowledgeable individuals contemporary to an important observation or discovery. It is the purpose of the chapters in this book to record and document many of the important events of contemporary neonatology and perinatology.

It must be remembered that it is presumptive of us to think that, at this early stage of contemporary neonatology and perinatology, we are able to select all the recent advancements and discoveries which will have a lasting and profound influence on these specialties. In spite of this qualification, we are capable of knowing that some discoveries will continue to be of fundamental importance in the future. The fact that, at the conference on which this book is based, we gave awards to six physicians for their contributions to neonatology or perinatology implies that a value judgement has been made. However, there is no doubt that, in fifty years, medical historians will be at a better vantage point for deciding which discoveries are most deserving for the part they played in affecting the survival and well being of the fetus and newborn infant.

History has a way of keeping us humble. I will remind you that medical history is replete with examples of individuals who made discoveries or contributions to medicine and received no recognition or reward for their work during their lifetime. I will give but two examples. The findings of Gregor Mendel (C. 1822-1884) on the transmission of inherited traits had a profound effect on biology and medicine but no honors came to him during his life. His observations were fundamental to biology and their implications were totally missed by his contemporaries. This omission occurred even though biologists and physicians were alerted to the fact that they lacked basic knowledge in the field of inherited traits. Mendel did very little scientific research after he reported his findings. He spent the remainder of his life with feelings of disillusionment and failure of accomplishment. It was sixteen years after his death before his discoveries received proper recognition. Dr. Ignaz Semmelweis (C. 1818-1865), the Hungarian obstetrician, anticipated Pasteur's findings by many years when he discovered how to prevent puerperal fever in the postpartum female. Not only were Semmelweis' findings ignored at the time, but he was ostracized by the obstetrical community for his propagation of what turned out to be good obstetrical principles. Semmelweis suffered severe depression during his life. His depression was accentuated by the lack of recognition for his contributions to medicine. He died a lonely man in an insane asylum. The purpose of our conference was not to pass judgement on historical events but merely to document the order in which these events occurred and to attempt to give some recognition to those individuals who were responsible for the development of important ideas or discoveries.

Future historians will have the final word when evaluating important medical discoveries. But we may be able to make their task easier by recording some neonatal and perinatal history now -- that is, if we can do it without interjecting too many subjective biases.